Spotlighting Two Communities that are Successfully Coordinating Healthcare and Housing Resources to End Veteran Homelessness – A ‘Hear from Your Peers’ Webinar
Webinar Format zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Our Webinar Format: Speakers will present for 12 minutes. Following all the speakers we will have approximately 25 minutes for Questions and Answers. How to ask questions: Question Box: Y ou may enter your question into the question box at any time during the presentation. We will read questions aloud and answer some after each speaker and then during the allotted Q&A session. Follow up questions: Contact information will be provided after each presentation and at the close of the webinar . Materials: Slides presented during the webinar will be made available after the webinar. For those who registered, copies will be emailed. For those participating at a later date, copies will be made available on the HUD Exchange.
H² Housing and Healthcare zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA T echnical Assistance Roula K. Sweis, M.A., Psy.D, Supervisory Program Advisor , Office of the Assistant Secretary for CPD H²: Housing and Healthcare TA - A Federal Partnership between HUD and HHS focused on improving program participant access and effective utilization of mainstream healthcare services at the systems level .
Today’s Presenters Roula K. Sweis, Supervisory Program Advisor , Office of the • Assistant Secretary for CPD Katy Miller, Regional Coordinator, United States Interagency • Council on Homelessness (USICH) Dr. Cynthia Dodge, Director of the VA’s Community Resource • and Referral Center (CRRC) for southern Nevada Michele Fuller-Hallauer, Continuum of Care Coordinator, • Southern Nevada Homelessness CoC Annamaria Gueco, Supportive Housing Department Manager, • Sound Mental Health, King County, WA Lisa Farsje, Substance Use Disorder Specialist, VA Supported • Housing, VA Puget Sound Healthcare System
Poll # 1 Does your city/county have a special initiative related to ending veterans’ homelessness? • Yes • No • Not sure
Southern Nevada Housing and Healthcare for Homeless Veterans Cynthia Dodge Ph.D., VA Community Resource and Referral Center (CRRC) Manager Michele Fuller-Hallauer, Continuum of Care Coordinator, Southern Nevada Homelessness CoC
Homeless Veterans 1800 1579 1600 1400 1200 1169 1000 986 Sheltered 897 Unsheltered 800 Total 706 692 651 593 600 464 518 406 375 400 433 300 317 200 0 2009 2011 2013 2014 2015
Jurisdictions CoC Coordinator Housing CoC Board Authority And CRRC Manager Providers
VA-CRRC and CoC Held Every 2 weeks for coordination and process improvement • SSVF program managers (1x month case managers) with CRRC Coordinated Intake staff. – additional meetings are held specifically for case conferencing. • Southern NV Regional Housing Authority with VA Managers and HUD VASH Supervisors. • Clark County /VA/CoC Providers for Coordinated Assessment Change Advisory Team – additional meetings held for case conferencing. • Municipalities/VA/CoC Providers related to Mayor’s Challenge and issues specific to affordable housing and employment Weekly meetings : • CRRC manager/VA outreach teams with all CoC community homeless outreach teams. – includes first responders, walk in community health centers, • CoC Coordinator and CRRC Manager to support and collaborate on updates/events/meetings needed to end Veteran Homelessness.
Veterans Dashboard 10
Coordinated Intake Outreach Walk-in CRRC CRRC Chronic and/or Non-Chronic Non-Chronic and/or Lower Vulnerability High and/or Lower Chronic and/or High Vulnerability Vulnerability Vulnerability Ineligible for Ineligible for VASH SSVF VASH SSVF Clark County Clark County Social Service Social Service Coordinated Intake=Housing Assessment/Permanent Housing Plan/ Emergency or Bridge Housing
Non-VA eligible Veterans
Coordinated Intake July 2014-August 2015
H2 Initiative 8/14/2015 State Leadership December 11-12, State Interagency Calls February 5, 2014 State H2 Council on 2015 March 25, 2015 Planning session Homelessness approves June 5, 2015 H2 subcommittees • H2 Initiative Action Plan integrated into the State Plan to End Homelessness
Poll # 2 How much coordination at the systems level is happening in your community between VA and CoC programs? • Quite a bit • Some, but not enough • Just beginning to make progress • Not much
PERMANENT Coordinating Care to Keep SUPPORTIVE HOUSING Veterans Housed
KING COUNTY 10-Year Plan to End Homelessness East King County Regional Plan South King County Regional Plan 5-Year Plan to End Veteran Homelessness 25 Cities Single Adult Coordinated Entry Client Care Coordination, Family Housing Connections, Youth Housing Connections, Familiar Faces Service-Enriched Housing Permanent Supportive Housing vs. Housing with Supportive Services Follows Housing First Principles Leverages County and RSN/Medicaid Dollars to fund supportive services
SOUND MENTAL HEALTH Mission - To strengthen our community and improve the lives of our clients by delivering excellent health and human services tailored to meet their needs Housing as a Strategic Goal Outcome: Moving to self- sufficiency and independence Goal: Secure affordable, stable housing for persons in recovery (assist the person, the community and the system) Strategy: Blend supportive services with housing through partnerships, acquisition and housing development
VETERANS SERVED BY SMH & VASH McDermott Place was first project in the nation to utilize project- based HUD-VASH vouchers. Currently provide services jointly to 46 project-based VASH residents in 4 intensive supportive permanent housing building in King County Gossett Place serves 20 high needs VASH veterans Collaborative relationship with Low-Income Housing Institute Evidence-Based Best Practices Motivational Interviewing, Harm Reduction, Trauma-Informed Care Wraparound Support for Veterans LIHI: collaborative support from on-site landlord and property management SMH: on-site housing stability services, including case management, individual & group counseling, employment services, and crisis intervention VASH: community-based housing stability and case management services; coordination and connection to mental health, chemical dependency, and medical service through larger VA medical system.
Coordinating MCDERMOTT PLACE Care to Keep Veterans Housed
CASE EXAMPLE: “GEORGE” 70 Year Old Single Male Veteran Income Approximately $500/Month Housed at McDermott X 3 years Occasionally Failing Apartment Inspections Cataracts Getting Worse Hearing Impairment History of Heavy Drinking (Doesn’t Feel it’s a Problem) Previously Denied DSHS “Home and Community Services” *Strengths: Likes his Housing, Enjoys Walking Around Neighborhood, Engaged With Case Management and On-Site Group Activities, No Other MH Symptoms, Multiple Interests (Reading, Music, Public Radio)
***GEORGE’S HOUSING CRISIS*** Apartment Becoming Much Worse: Risk for Eviction Increasing Quickly Angry About Warnings Becoming Suspicious Towards VA and McDermott Staff, Starting to Decline Case Management Appointments Becoming Legally Blind Due to Cataracts, Restricting His Ability to Get Around, Grocery Shop, Pay Bills, Read Mail and Exaggerates His Hearing Impairment Stops Going to Medical Appointments (Pre-Surgery for Cataracts, Primary Care, etc.) Drinking Increases
WHAT ARE THE PRIORITIES AND WHO DOES WHAT? Enforce Apartment Standards (Health and Safety of the McDermott Community, Relationship with Housing Authority, etc.)? Help Vet Clean His Apartment? Who Will Do This? Help Vet Read His Mail, Pay Bills, Etc.? Help Vet Access Meal Delivery Program? Help Vet Get Assistive Devices for Blindness? Help Vet Get Cataract Surgery so He Can Regain Independence and Quality of Life? Repair Therapeutic Alliance?
COORDINATION OF CARE EVERYONE: Repair Therapeutic Alliance Through Expressions of Compassion/Concern, Offering Hands-On Assistance and Resource Referral, Exploring Pros/Cons of Change (Eye Surgery, Drinking). Interventions Later in the Day, etc. LOW INCOME HOUSING INSTITUTE: - Choosing Which LIHI Staff Member Vet Responds Best to - Reinforcing Options to Resolve the Crisis (Via Case Managers) - Expressing Hope that Vet Can Remain at McDermott - Gentle Reminders of Why Standards are Being Enforced - Providing “Starter Kit” of Cleaning Supplies, for Interim Choreworker - Coordinating with VA and SMH Staff Regarding Time-Frames, and Housing Authority Expectations
COORDINATION OF CARE, CONTINUED VA: (Includes Transportation) - Assisting with LIHI Communication - Referral: DSHS Re-assessment for “Home and Community Services,” Including Lengthy Detailed Advocacy Letter - Referral: King County Veterans for Interim Choreworker and Vet’s Own Cleaning Supplies - Hands-On Assistance With Reading Mail, Paying Bills, etc. - Re-engage in VA Medical Care (Vet Receives Objective Feedback Regarding Drinking) - Vet Eventually Becomes Willing to Attend Pre-Surgery Eye Appointments but Needs Frequent Reminders/Prompting
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